Individual
MRS. TRICIA K. GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
7260 UNIVERSITY AVE NE, SUITE 235, FRIDLEY, MN 55432-3126
(763) 572-2605
(763) 572-2606
Mailing address
1849 73RD ST, CENTERVILLE, MN 55038-9626
(651) 653-8036
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT 1081
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81G95GI
BCBS OF MN
MN
Enumeration date
08/31/2006
Last updated
07/09/2007
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